Water and labour pain: Does getting into a bathtub or jacuzzi help?

Getting into water in labour is really just a matter of preference for a woman. There are not very strong medical reasons either for or against birthing pools during labour.

Many birth centres and hospitals offer women the opportunity to get into water in labour. They will have a bathtub or jacuzzi in the delivery suite, often called a birthing pool. The choice of whether or not to get in the birthing pool is left to the woman. People who are strongly 'for' birthing pools say it will be a relief for the woman. What's more, they say that a bath will reduce the pain and help prevent perineal tears. But others are concerned that if there is an emergency, important time can be lost getting the woman out of the bath. They also worry about complications for the baby, for example from breathing in water if they are born in the tub.

To answer these questions, researchers gathered together and systematically evaluated trials that tested the effect of birthing pools. This search for evidence showed that the potential advantages and disadvantages of giving birth in water have not yet been studied well enough to allow a confident judgment to be made.

However, the researchers found eleven trials altogether, in which women did not give birth in water but spent some time in water during labour.

The results indicate that getting in a tub can help some women. One small trial showed that about 2 out of 10 women who spent time in water before birth experienced their contractions as less painful than women who did not get in the water. Six other trials involving about 2,400 participants looked at whether taking a bath in labour influenced whether women needed an epidural or similar pain-relieving measures. The results: 62 out of 100 women (62%) who spent time in a bath did not need pain-relieving measures like this, compared to 58 out of 100 women (58%) who did not spend time in the bath. In other words, 4 less women out of 100 needed an epidural or similar pain relief if they spent some time in a bath before giving birth. You can read more about epidurals here.

There was no reduction in episiotomy or perineal tears though. The rate of caesarean sections and births assisted with forceps was not reduced by spending time in water during labour either.

Babies did not seem to be harmed by their mothers spending time in water during labour. However, the possibility that a baby could develop an infection cannot be excluded by the available evidence.

The studies also showed that women are divided about birthing pools. In one of the studies, for example, about half the women who were offered the birthing pool chose not to use it.

You will find more detailed information about coping with pain during labour here.


Author: German Institute for Quality and Efficiency in Health Care (IQWiG)

© IQWiG (Institute for Quality and Efficiency in Health Care)